A systematic review of binge drinking interventions and bias assessment among college students and young adults in high-income countries.

Alcohol is the number one substance used by young people and people of college age. Binge drinking (BD) in this age group is considered one of the most important global health issues, as much harm accrues from it and even lives are lost. This study aimed to review the interventions to curb BD or encourage responsible drinking among college students and young adults. MEDLINE (PubMed), ERIC and APA PsycINFO were searched. The selected articles were published in English and had to evaluate a BD reduction program through a randomized control trial (RCT) among college students or young adults between the ages of 17-24 years. The exclusion criteria included research not published in English, systematic review articles, qualitative studies, designs other than RCTs and discussion articles on college students drinking with no findings. The three reviewers independently screened and extracted the data using the PRISMA guidelines. The overall quality of the studies was assessed. Then, 10 of the 12 interventions studied were found to be successful in reducing BD among college students, though the effect sizes were small to medium. A minority of the studies used behavior change theories. Effective interventions for reducing BD among college students and young adults should include robust behavior change theories, longer follow-up time and the operationalization of multiple outcomes. Process evaluation is needed to be conducted in these studies.

Theory-based antecedents of breastfeeding among pregnant women in the United States.

Background: Breastfeeding provides several positive health benefits for the newborn child, yet breastfeeding rates remain low in the United States (US). Theory-based approaches have the potential to improve breastfeeding promotion interventions. Hence, the study examined the correlates of intention to breastfeed among US pregnant women based on the multi-theory model (MTM) of health behavior change. Methods: Using a cross-sectional design, a 36-item online survey was administered to a nationally representative sample of 315 pregnant women in the US. The instrument was psychometrically validated for face, content, and construct validity by a panel of six experts over two rounds. Further, construct validation was done by confirmatory factor analysis (CFA). Hierarchical regression modeling was employed to explain the intention to start breastfeeding and sustain exclusive breastfeeding for up to six months and with complementary foods for up to 24 months. Results: Internal consistency using Cronbach's alpha was found to be acceptable. It was found that behavioral confidence and changes in the physical environment positively affected the initiation of breastfeeding (P<0.01; adjusted R2=0.478). All three constructs of MTM namely practice for change, emotional transformation, and changes in the social environment were significant predictors for the sustenance of breastfeeding at six months (P<0.01; adjusted R2=0.591) and at 24 months (P<0.01; adjusted R2=0.347). Conclusion: Based on the findings of this study it is essential for educators and healthcare providers to design MTM-based interventions to promote breastfeeding among pregnant women in the US.

Examining the Gambling Behavior of University Students: A Cross-Sectional Survey Applying the Multi-Theory Model (MTM) of Health Behavior Change in a Single Institution.

Gambling among college students can start as a pastime activity. However, this pastime can lead to problem gambling and pathological gambling. This cross-sectional study aimed to identify and explain the initiation and sustenance of quitting gambling among university students who had participated in gambling during the past month and those who had not using a novel fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from a sample of 1474 university students at a large southwestern university in the U.S. between January 2023 and February 2023, utilizing a validated 39-item survey. The statistical analyses employed in this study encompassed descriptive statistics, independent samples t-tests, and hierarchical regression modeling. Among students who had engaged in gambling in the past month, the constructs of participatory dialogue (ß = 0.052; p < 0.05), behavioral confidence (ß = 0.073; p < 0.0001), changes in the physical environment (ß = 0.040; p = 0.0137), and demographic variables accounted for 27.7% of the variance in the likelihood of initiating the behavior change. Furthermore, the constructs of emotional transformation (ß = 0.104; p = 0.0003) and practice for change (ß = 0.060; p = 0.0368), and demographic variables accounted for 22.6% of the variance in the likelihood of sustaining quitting gambling behavior. The Multi-Theory Model (MTM) can be employed to design interventions aimed at reducing problem gambling among college students.